Northwestern Medical Center, Inc
Organization Active NPI Pediatrics Physician · Saint Albans, VT
NPI 1003574740 · NPPES record last updated Mar 8, 2022
Key facts
- NPI
- 1003574740
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- Legal business name
- NORTHWESTERN MEDICAL CENTER, INC
- Practice address
- 133 Fairfield St
Saint Albans, VT 05478-1726 - Phone
- (802) 524-1040
- Fax
- (802) 524-1032
- NPI assigned
- Nov 30, 2021
- Organization subpart
- No
Authorized official
- Name
- Dennis J Boucher
- Title
- Director
- Phone
- (802) 524-1276
Other NPIs on the same Medicare enrollment 1
Practitioners 227
-
Aimee Nazebeh Ahari, PA-C
-
Jolanta Teresa Amblo, M.D.
-
Steven D Anisman, MD
-
Lindsay Claire Arzberger, FNP-C
-
Robert N Beattie, M.D.
-
Jared Andrew Blum, M.D.
-
Kristen E Bond-Webster, PA-C
-
Joseph Matthew Boone, NP-C
-
Jacqueline Moriah Bray, DNP-FNP
-
Jason Douglas Brazelton, M.D.
-
Gregory Jason Brophey, M.D.
-
Michele Hoshiko Burke, M.D.
-
Ann Carpenter, NP
-
Lucas James Carter, PA-C
-
Derek Chase, MD
-
Benjamin Chaucer, M.D.
-
Emanuele Q Chiappinelli, M.D.
-
Sara T. Child, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041006001249 | VT | Part B Supplier - Clinic/Group Practice | 5496714313 |
Receives reassigned benefits from 82 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Saint Albans, VT |
National Provider Directory
Locations
219 S Main St
Middlebury, VT 05753
Phone (802) 443-5259
260 Crest Rd
Saint Albans, VT 05478
Phone (802) 524-8805
133 Fairfield St
Ste 102
Saint Albans, VT 05478
Phone (802) 524-5911
133 Fairfield St
Ste 101
Saint Albans, VT 05478
Phone (802) 524-1232
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | Yes |
Addresses
Primary practice location
133 Fairfield St
Saint Albans, VT 05478-1726
Mailing address
133 Fairfield St
Saint Albans, VT 05478-1726
Phone (802) 524-5911
Other names
- Northwestern Family Birth Center
Other providers in Saint Albans, VT
- Northwestern Medical Center
- Northwestern Medical Center
- Northwestern Medical Center
- Northwestern Medical Center Inc
- Northwestern Medical Center Inc
- Northwestern Medical Center, Inc
- Northwestern Medical Center, Inc.
- Northwestern Medical Center, Inc.
- Northwestern Medical Center, Inc.
- Northwestern Medical Center, Inc.
All providers in Saint Albans, VT · Pediatrics Physician in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 8, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.